Sociodemographic and clinical factors associated with delayed diagnosis of cervical cancer: a cross-sectional study, Brazil, 2016-2020.

Objectives: To assess the time taken to diagnose cervical cancer in Brazil and identify associated sociodemographic and clinical factors in the period 2016-2020.

Methods: This was a cross-sectional study of cervical neoplasms diagnosed between 2016 and 2020, using data collected from the Hospital Cancer Registry. The logistic regression model was applied to calculate odds ratios (OR) and 95% confidence intervals (95%CI). The estimates were converted to prevalence ratios (PR). A 5% significance level was adopted for all analyses.

Results: A total of 23,548 cases were evaluated. Prevalence of delayed diagnosis of cervical cancer was higher in women with no formal education (PR 1.40; 95%CI 1.19; 1.65), of Black or mixed race/skin color (PR 1.15; 95%CI 1.06; 1.25), living in the Northern region (PR 1.37; 95%CI 1.21; 1.55), referred by the Brazilian National Health System (PR 1.29; 95%CI 1.18; 1.41) and with diagnosis in 2020 (PR 1.29; 95%CI 1.16; 1.43). Delayed diagnosis was less frequent among women with stage III (PR 0.31; 95%CI 0.28; 0.35) and stage IV (PR 0.37; 95%CI 0.32; 0.42) cervical cancer.

Conclusion: Delayed diagnosis of cervical cancer is associated with sociodemographic inequalities and challenges faced by the Brazilian National Health System. Prevalence of delayed diagnosis was higher among Black women, women with less education and women from the Northern region. The results reinforce the need to strengthen the line of care and qualify diagnostic confirmation processes, especially for socially vulnerable populations.